For years, we’ve heard that dogs can be good for human physical and mental health in part because the canines’ need for exercise gets their sluggish human companions out of the house for a walk at least a couple of times a day.

Now some University of Pennsylvania researchers point out that those walks sometimes end in broken bones and trips to the emergency room for older dog walkers. They estimate that nationally, the number of dog-walking fractures in people aged 65 and older more than doubled between 2004 and 2017, from 1,671 to 4,396. During that period, the number of older adults increased by 10 percent, or 4.6 million. Because the team’s data included only people seen in emergency rooms, the researchers believe there likely are more dog-walking-related fractures than they were able to count.

The results were published recently in a research letter in JAMA Surgery.

The Penn team included medical student Kevin Pirruccio and senior author Jaimo Ahn, an orthopedic surgeon who studies bone healing. They searched for a topic that would have broad societal importance, Ahn said, even if it lacked the biological heft of his usual work.

Pirruccio suggested looking in the National Electronic Injury Surveillance System database of the U.S. Consumer Product Safety Commission. They found entries for injuries related to pet products treated at 100 emergency rooms, then extracted the ones related to walking dogs on leashes. After analyzing those, they estimated national injury levels.

More women fall

Seventy-nine percent of the victims were female. That’s not surprising, Ahn said, because older women tend to have weaker bones than older men. Hip fractures were the most common, making up 17 percent of the total. That’s bad news, because hip fractures can lead to increased disability and even death in the elderly. Injuries to the wrist, arm, and finger were next in frequency. Twenty-nine percent of the fracture victims required admission to the hospital.

People ages 65 to 75 accounted for about half of the injuries in the studies.

To put this all in perspective, though, Ahn estimated that dog walking leads to less than 1 percent of all fractures in the U.S.

The researchers could not study how the injuries occurred. Did people trip over their dogs or did the dogs pull them down or push them over? They also don’t know how big the dogs or their walkers were.

In Ahn’s personal experience repairing dog-walking damage, the most common scenario is “small person/big dog,” he said.

He assumes that part of what’s going on is that older Americans are more active than they used to be. The price for that is more injuries.

He also thinks more seniors own dogs, but that part is harder to prove. Dog statistics vary widely. The American Veterinary Medical Association says that the percentage of households owning dogs has been relatively stable over the last 10 years, at 37 to 38 percent. It did not have statistics on dog ownership among older adults.

Resistance isn’t futile

Ahn said older adults can reduce their odds of broken bones by being active and engaging in resistance exercises. That helps keep bones strong and helps people maintain their balance.

Ahn does not have a dog himself. He has a small pet tortoise. He does have lots of friends with dogs, though. “Some of them are really well-trained, but others are really poorly trained,” he said.

Noelle Knight, a veterinarian at PetPT in Cherry Hill, N.J., agreed the “most important thing really is appropriate training. Pretty much any dog can learn new tricks.” All dogs naturally walk faster than people, she said, and they need to learn to walk at a slower pace. Older people with dogs that are too excited by other dogs in the neighborhood might want to consider walking at less busy times.

Choose wisely

Michael Blackwell, a veterinarian who directs a program meant to improve access to veterinary care at the University of Tennessee, Knoxville, said safety starts with pet selection. “Matching a pet with a family is really important, and this is across age categories,” he said.

Knight thinks this is more important than the size of the dog. She said it’s wise to talk to a trainer before you choose a dog. Some will even go with you to pick a dog.

Grace Ann Mengel, a veterinarian who runs the primary care service at Philadelphia’s Ryan Veterinary Hospital, said older people might want to steer clear of shelter dogs that have a lot of energy or anxiety. “Training doesn’t cure all,” she said. Good shelters can help match people with appropriate dogs. “There are dogs that have a quieter nature who do need homes.”

She thinks breeders can also be good resources, because personality is easier to predict in purebred dogs.

Knight said the best gear for dogs that pull is either a harness that attaches in front or a head halter. (Gentle Leader and Halti make halters.) She said old-fashioned leashes are usually best. Leashes that have a retractable component or a bungee teach dogs there’s some give in the leash. That basically rewards them for pulling.

Mengel said choke or pinch collars may also be appropriate for certain situations. Dogs should only wear choke collars when they are outside and supervised. If the collars get caught on something, they can literally choke the dog. She said owners should choose leashes that feel comfortable to them. Flat nylon leashes cut into her hand. She prefers a round, rope leash made by Mendota or leather leashes.

She’s not a fan of harnesses for larger dogs. They make it hard to control the front end of the dog’s body, including the head. This can be a problem when dogs are overly interested in other dogs or people.

Blackwell pointed out that dog ownership is not for everyone. “There are some people who would be best off not having a dog,” he said. “Just because someone wants one doesn’t mean it’s a good fit.”